Tubaovaryan apse nedeniyle takip edilen hastalarin klinik yönetiminin sistemik inflamatuar yanit indeksleri ile değerlendirilmesi

Evaluation of clinical management of patients with tubaovarian abscess using systemic inflammatory response indices INTRODUCTION AND AIM: In this study, we aimed to retrospectively evaluate the socio-demographic findings, clinical and laboratory results of patients treated for tuboovarian abscess (TOA) in our clinic, to examine the treatment methods applied, and to investigate the usefulness of the systemic immune response index (SIRI) and systemic immune inflammation index (SII) before and after treatment in the management of TOA. MATERIALS AND METHODS: Between January 2021 and December 2023, the records of 68 patients who were followed up in our Gynecology and Obstetrics clinic at Sakarya University Training and Research Hospital between January 2021 and December 2023 with a diagnosis of TOA were retrospectively analyzed, 4 patients were excluded from the study. Socio-demographic data, risk factors, clinical and laboratory results, and treatment modalities were recorded. RESULTS: The mean age of the patients was 42.39±9.63 years, ranging from 18 to 75 years. 81.3% of the patients were multiples. The main complaints were pelvic pain (100%), fever (40.6%), nausea and vomiting (51.6%) and vaginal discharge (79.7%). All patients received medical treatment. It was determined that 11 patients recovered only with medical treatment and 53 patients recovered with surgical treatment in addition to medical treatment. Two patients were excluded from the study due to treatment refusal and the other 2 patients were excluded due to medical+percutaneous drainage treatment. Of all patients who underwent surgery; 10 patients underwent drainage, 19 patients underwent salpingectomy, 20 patients underwent salpingoooferectomy, and 4 patients underwent TAH+BSO. No complications were observed in patients who underwent surgery. There was a significant decrease in Hemoglobin, Leukocyte, Neutrophil, Monocyte, CRP, SIRI and SII values and a significant increase in Lymphocyte and Platelet values. CONCLUSION: TOA is an important disease that can cause serious mortality and morbidity. Therefore, the ideal treatment method should be determined by taking into consideration the patient's age, clinical features and pregnancy demand. Systemic inflammatory indices may gain importance in clinical follow-up but cannot be used as a marker of inflammation. Large randomized controlled prospective studies are needed in this regard. Keywords: Medical treatment, pelvic inflammatory disease, surgical treatment, systemic inflammatory response index, tubaovarian abscess